Background: Wounds that are chronic and complex at the same time continue to be a main clinical problem globally, frequently resulting in the patient's wellness being compromised for a long time, huge medical expenses, and low quality of life for the patient. Negative pressure wound therapy NPWT or vacuum-assisted closure VAC has been considered the most superior wound management method and has gained broad clinical acceptance in the last twenty years.

Objective: This paper serves as a survey aiming to dissect the biological mechanisms, clinical indications, contraindications, procedural considerations, and current evidence supporting NPWT in detail. Furthermore, it addresses future directions and innovations in NPWT.

Methods: For the period of 1997-2025 literature covering the topic was systematically reviewed from the databases PubMed, Scopus, and Web of Science using the terms negative pressure wound therapy, vacuum-assisted closure, chronic wound management, and wound healing technology. Randomized controlled trials RCTs, meta-analyses, and evidence-based clinical guidelines were given priority.

Results: Evidence shows that NPWT leads to quicker closure of the wound, lower infection risk, and better granulation tissue formation. It has been proven to be useful for diabetic ulcers, pressure injuries, surgical wounds, burns, traumatic injuries, and defects in the skin. Not treating osteomyelitis, necrotic tissue with eschar, malignancy in the wound, and exposing vital structures are counted as contraindications by the authors.